Copyright © 2018, Elsevier Inc. All Rights Reserved. 1
Chapter 05: Cultural Influences in Nursing in Community Health
Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition
MULTIPLE CHOICE
1. Which of the following best describes most Americans’ attitude toward immigrants?
a.Ambivalence because there are no clear solutions about how to address their
needs
b.Strongly negative because immigrants take jobs that native-born Americans could
have instead
c.Strongly positive because immigrants bring useful job skills and often join
previous family members already in the United States
d.Strong opposition to further immigration because of the increasing population in
the United States
ANS: A
Most Americans are ambivalent about immigration, recognizing both the positive and negative aspects involved and realizing that
it is a complex issue that has no clear solutions. Because Americans’ have an attitude of ambivalence, there is not strong negative
or positive attitudes towards immigrants. However, many times immigrants do enter the United States because the have useful job
skills or family ties. They are more likley to be a low-income worker who works in low-wage, blue-collar jobs and industries.
2. A nurse is about to despair. Earlier in the week, she carefully taught a patient from a different culture exactly how much medication
to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with
symptoms of an overdose although the patient denies taking more than the label indicated. Which of the following is the most likely
explanation?
a.The patient was taking more mediation in the hope of getting well faster.
b.The patient was also taking folk medicines that had many of the same effects and
perhaps some of the same ingredients as the prescribed medication.
c.The patient truly did not understand and thought the dose being taken was correct.
d.The patient had a unique response to the medication and should have a smaller
dose ordered.
ANS: B
For fear of disapproval, a person may not tell the nurse that he or she is using folk medicine as well as Western medication. The
two medicines may have cumulative effects that could be dangerous to the client. Nurses who lack cultural knowledge may develop
feelings of inadequacy and helplessness because they are often unable to effectively help their clients. It is unlikely that tne patient
was taking too much medication, taking the incorrect dose, or having a unique reaction to the medication. Rather the nurse should
first interview the patient about use of folk medicine which may interact with the prescribed medication regimen.
3. A nurse wishes to develop cultural competence. Which of the following actions should the nurse take first?
a.Complete a survey of all the various ethnicities represented in the nurse’s
community.
b.Consider how the nurse’s own personal beliefs and decisions are reflective of his
or her culture.
c.Invite a family from another culture to join the nurse for an event.
d.Study the beliefs and traditions of persons living in other cultures.
ANS: B
Cultural awareness requires self-examination and an in-depth exploration of one’s own beliefs and values as they influence
behavior. Cultural awareness is the first element in the model of cultural competence. Following the development of cultural
awareness, the next step is cultural knowledge in which information about organizational elements of diverse cultures and ethic
groups is collected. The next stage of the model, cultural skill, occurs with the effective integration of cultural awareness and
cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. The fourth construct essential to
this model is cultural encounter which is the process that permits nurses to seek opportunities to engage in cross-cultural
interactions with clients of diverse cultures to modify existing beliefs about a speciifc cultural group.
4. A nurse is caring for a client of another culture. Which of the following actions would be most appropriate for the nurse to take?
a.Alter personal nonverbal behaviors to reflect the cultural norms of the client.
b.Keep all behaviors culturally neutral to avoid misinterpretation.
c.Rely on friendly gestures to communicate caring for the client.
d.Avoid any pretense of prejudice by treating the client in the same way as any
other client.
ANS: A
Cultural competence in nursing includes adoption of culturally congruent behaviors. Culturally skillful nurses use appropriate touch
during conversation, modify the physical distance between themselves and others, and use strategies to avoid cultural
misunderstandings while meeting mutually agreed-upon goals. Nurses who strive to be culturally competent respect people from
other cultures and value diversity, which helps them to provide more responsive care. Nurses should be knowledgeable of other
cultures and communicate with the client based on cultural norms. Cuturally skillful nurses understand the unique difference among
individuals within a given culture and work with those individuals to learn more about their culture and provide culturally sensitive
care.